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Biomarker Development for Response Prediction by DNA Mutational Analysis (CPCT-01)

7 mars 2018 uppdaterad av: P.O. Witteveen

Feasibility Study of Biomarker Development for Response Prediction by Large Scale DNA Mutational Analysis of Metastatic Lesions

The purpose of this study is to determine whether it is possible to predict response to chemotherapy in patients with metastatic cancer who are treated with irinotecan by determining the mutational profile of the tumor.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Studietyp

Observationell

Inskrivning (Faktisk)

79

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Nederländerna
      • Utrecht, Nederländerna, 3584 CX
        • University Medical Center Utrecht
    • North Holland
      • Amsterdam, North Holland, Nederländerna, 1066 CX
        • Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital
    • South Holland
      • Rotterdam, South Holland, Nederländerna, 3075 EA
        • Erasmsus Medical Center - Daniël den Hoed clinic

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Testmetod

Sannolikhetsprov

Studera befolkning

Patients with a metastatic solid tumor who are eligible for (standard of care) treatment with irinotecan.

Beskrivning

Inclusion Criteria:

  1. Patients with a metastatic solid tumor who have failed at least one line of palliative chemotherapy and are irinotecan naïve.
  2. Patients who are, as per local protocol, eligible for palliative treatment with (standard of care) irinotecan.
  3. Measurable metastatic lesion(s), according to RECIST 1.1 criteria.

  4. Radiological measurable metastatic lesion(s) of which a histological biopsy can safely be obtained:

    1. Patients with safely accessible metastases.
    2. Patients not known with bleeding disorders (such as hemophilia) or bleeding complications from biopsies, dental procedures or surgeries.
    3. Patients not using any anti-coagulant medication at the time of biopsy: all aspirin derivatives, NSAID's, coumarines, platelet function inhibitors, heparins (including LMWHs) and oral factor Xa inhibitors are not allowed, unless medication can either be safely stopped or counteracted.

    4. Adequate coagulation status on the day of biopsy as measured by:

      • PTT < 1.5 x ULN
      • APTT < 1.5 x ULN
      • Platelet count 100 x 10*9 / L or higher
      • PT-INR < 1.6
      • HB > 6
    5. Biopsies should be performed at least four weeks after last bevacizumab administration.
  5. Patients age 18 years or up, willing and able to comply with the protocol as judged by the investigator with a signed informed consent.

Exclusion Criteria:

Patients not meeting all of the above inclusion criteria.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

Kohorter och interventioner

Grupp / Kohort
Intervention / Behandling
Irinotecan

Patients will be subjected to a their metastatic solid tumor. Radiological response will be evaluated after each 2 cycles: 1. percentage change in radiological volume of the "index lesion" (radiological measurable lesion that underwent biopsy) after the first two cycles of irinotecan; 2. radiological response according to RECIST 1.1 after each 2 cycles. Patients are intended to receive irinotecan until progressive disease or unacceptable toxicity. Patients will be subjected to another biopsy of the index lesion at definitive discontinuation of irinotecan. Patients will also be subjected to blood draws for determining patient's genetic background variation.

Side studies include:

  • pharmacogenetics
  • pharmacokinetics of SN-38
  • carboxylesterase activity in the index lesion
  • midazolam clearance test (only in Rotterdam patients)
Procedur: Biopsy
Histological biopsy of the "index lesion" (a radiological measurable lesion on which biopsy is performed) at baseline, as well as when showing progressive disease. Histological biopsies will be subjected to DNA sequencing to assess the mutational profile, as well as to analysis of carboxylesterase activity.
Andra namn:
  • Histological biopsy
Procedur: Blood samples
Blood samples will be taken at baseline to determine patient's genetic background variation (germline DNA).
Andra namn:
  • Blodprovtagning
Procedur: Pharmacokinetics
Blood samples will be taken for pharmacokinetic analysis of the active irinotecan metabolite (SN-38).
Andra namn:
  • PK
  • Pharmacokinetic analysis
  • Pharmacokinetic analyses
Procedur: Midazolam clearance test
Patients who are being treated in Rotterdam will be subjected to blood draws for validation of the earlier developed midazolam phenotyping test (midazolam clearance test), which may be an indicator for pharmacokinetics of irinotecan.
Andra namn:
  • MCT

Vad mäter studien?

Primära resultatmått

Resultatmått
Tidsram
Exploration of the correlation between the mutational profile and the percentage change in volumetric measurement of the index lesion after the first two cycles of chemotherapy.
Tidsram: Change in radiological volume of the index lesion after the first 2 cycles of irinotecan. Radiological response (according to RECIST 1.1) after the first 2 cycles of irinotecan (i.e. after 2 x 3 weeks = 6 weeks)
Change in radiological volume of the index lesion after the first 2 cycles of irinotecan. Radiological response (according to RECIST 1.1) after the first 2 cycles of irinotecan (i.e. after 2 x 3 weeks = 6 weeks)

Sekundära resultatmått

Resultatmått
Tidsram
Exploration of the correlation between the mutational profile and radiological response according to RECIST-criteria after the first two cycles of chemotherapy.
Tidsram: Analysis 6 weeks after initiation of treatment
Analysis 6 weeks after initiation of treatment
Exploration of the correlation between the mutational profile and progression free survival and overall survival.
Tidsram: Overall survival approximately after 2 years of first cycle of irinotecan. Progression free survival approximately 3 months after first irinotecan
Overall survival approximately after 2 years of first cycle of irinotecan. Progression free survival approximately 3 months after first irinotecan
Exploration of the correlation between the mutational profile of the index lesion and patient's germline DNA background variation.
Tidsram: Analysis after progressive disease, on average after 3 months.
Analysis after progressive disease, on average after 3 months.
Differences in mutational profile of metastasis prior to and after exposure to treatment.
Tidsram: Analysis after progressive disease and subsequent post-treatment biopsy, on average after 3 months of treatment
Analysis after progressive disease and subsequent post-treatment biopsy, on average after 3 months of treatment
Determine reliable and valid strategies for statistical analysis for biomarker discovery
Tidsram: 2 years
2 years
Correlate response to pharmacokinetics of SN-38
Tidsram: After progressive disease and subsequent post-treatment biopsy, in general after 3 months of treatment
After progressive disease and subsequent post-treatment biopsy, in general after 3 months of treatment
Determine carboxylesterase activity in metastatic tumor material (pre- and posttreatment) and correlate intra-tumoral carboxylesterase activity to systemic SN-38 pharmacokinetics and to irinotecan response
Tidsram: After progressive disease and subsequent post-treatment biopsy, in general after 3 months of treatment
After progressive disease and subsequent post-treatment biopsy, in general after 3 months of treatment
Determine clinical applicability of the midazolam phenotyping probe
Tidsram: After first cycle of irinotecan, at three weeks
After first cycle of irinotecan, at three weeks
Number and nature of all (serious) adverse events of study related procedures
Tidsram: 14 days after baseline biopsy and 14 days after post-treatment biopsy (approximately after 3 months of treatment)
14 days after baseline biopsy and 14 days after post-treatment biopsy (approximately after 3 months of treatment)

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

P.O. Witteveen

Samarbetspartners

Erasmus Medical Center
The Netherlands Cancer Institute

Utredare

  • Huvudutredare: Marlies Langenberg, MD/PhD, UMC Utrecht
  • Huvudutredare: Neeltje Steeghs, MD/PhD, Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Amsterdam
  • Huvudutredare: Ron Mathijssen, MD/PhD, Erasmus Medical Center - Daniël den Hoed clinic, Rotterdam

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 maj 2011

Primärt slutförande (Faktisk)

1 november 2015

Avslutad studie (Faktisk)

1 augusti 2016

Studieregistreringsdatum

Först inskickad

1 augusti 2011

Först inskickad som uppfyllde QC-kriterierna

13 maj 2013

Första postat (Uppskatta)

16 maj 2013

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

9 mars 2018

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

7 mars 2018

Senast verifierad

1 mars 2018

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • NL35198.041.11

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